Cognitive behaviour therapy within assertive outreach teams: barriers to implementation: a qualitative peer audit.

Full Abstract

Assertive outreach is an evidence-based intervention, with over 30 well-designed randomized studies demonstrating its effectiveness, predominately in the USA. Assertive outreach teams have recently been implemented in the UK, and it has been recommended that teams should offer cognitive behaviour therapy (CBT) to service users; however, it has been reported that barriers exist in the routine delivery of CBT for psychosis (CBTp). The aim of the peer audit was to gauge current opinion from clinicians whether their experiences of barriers to implementation of CBTp reflected that outlined in the literature. A qualitative peer audit was undertaken at the National Forum for Assertive Outreach Annual Conference in 2006. The team representatives were invited to outline the barriers to the implementation of psychosocial interventions within their local areas. Teams identified organizational, managerial, supervision and local specific barriers to implementation. Specific comments included a lack of organizational investment, the structured nature of CBT, caseload issues, medication issues, application to people with sensory impairments, staff apathy and staff burnout. The analysis was limited by the metholodology employed; however, further recommendations are explored. It was evident from this peer audit that teams are experiencing barriers relating to the implementation of evidence-based therapy interventions and further research is required on the outreach model and the use of CBTp.

Author information

Author/s: Williams, C H J (CH);

Affiliation: User Friendly Psychiatry Ltd, Northwich, Cheshire, UK. caroline.williams(-atsign-)ufpmentalhealth.com

Journal and publication information

Publication Type: Journal Article; Review

Journal: Journal of psychiatric and mental health nursing (J Psychiatr Ment Health Nurs), published in England. (Language: eng)

Reference: 2008-Dec; vol 15 (issue 10) : pp 850-6

Dates: Created 2008/11/17; Completed 2009/02/13;

PMID: 19012676, status: MEDLINE (last retrieval date: 2/18/2009, IMS Date: )

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

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